Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins

B4153 is the Healthcare Common Procedure Code System (HCPCS) code used to bill for this item.

Note: The estimates below are based on Medica Choice network contract rates. How were these costs calculated?

Cost Key:
Lower Cost Medium Cost Higher Cost
Facility     City/State Average Cost Range    
  Fairview Home Infusion Minneapolis, MN $1.71 - $2.07
  Fairview Cedar Ridge Pharmacy Apple Valley, MN $1.71 - $2.07
  Pediatric Home Services Roseville, MN $7.65 - $8.12
  Sanford HealthCare Accessories Bemidji, MN $1.71 - $2.07